Advance medical directives help with end-of-life decisions

Every day in hospitals, nursing centers and private homes, patients, residents and families make pivotal decisions about medical care at the end of life. These decisions range from demanding every high-tech tool in the medical arsenal to extend a patient's life, to comfort care measures that can ease the passage of a patient in hospice. They can be the most difficult decisions family members and designated healthcare agents ever face.

Early guidance from the patient in the form of an Advance Care Plan (ACP) or Advance Directive can reduce family disagreements and ease the emotional burden of these decisions. It is also helpful to know that comfort care does not mean 'giving up.' It is an active medical protocol focused on pain relief and symptom management that allows patient and family more quality time together.

Sometimes the decision is clear, such as a declaration of brain death after an accident, stroke or aneurysm. However, when a patient's condition and prognosis are less defined, the absence of an ACP can cloud healthcare decisions with doubt, guilt and uncertainty over what the patient would want.

In Virginia, if you have not filed an Advance Care Plan, your spouse automatically assumes the role of agent. In some families, another person might be better suited to that role, such as a sibling, an adult child or a trusted friend. The agent you name in your Advance Care Plan should be someone who understands your views on end-of-life care and will carry out your wishes.